Subtle ocular movements in a patient with brain death

Introduction and Case Presentation: Brain death can be associated with limb movements that are attributed to spinal reflexes. Although head/face movements have been rarely reported, no case of overt eye movements in brain death has been documented. We report a case of a patient with subtle eye movem...

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Bibliographic Details
Published inJournal of stroke and cerebrovascular diseases Vol. 29; no. 9; p. 104913
Main Authors Fattal, D, McDaniel, J, Leira, EC, Schmidt, GA
Format Journal Article
LanguageEnglish
Published United States Elsevier Inc 01.09.2020
Subjects
Brain Death - diagnosis
Brain Death - physiopathology
critical care
Death, Sudden, Cardiac - etiology
Delayed Diagnosis
Eye Movements
Humans
Middle Aged
practice guidelines as topic/standards
Predictive Value of Tests
reflex/physiology
Time Factors
Tissue and Organ Harvesting
tissue and organ procurement
Tissue Donors
brain death/diagnosis
critical care
eye movements
tissue and organ procurement
practice guidelines as topic/standards
reflex/physiology
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Summary:Introduction and Case Presentation: Brain death can be associated with limb movements that are attributed to spinal reflexes. Although head/face movements have been rarely reported, no case of overt eye movements in brain death has been documented. We report a case of a patient with subtle eye movements whose exam was otherwise consistent with brain death. The presence of eye movements delayed pronouncing the patient as brain dead and delayed organ donation. We agree with American Academy of Neurology Position statement from 2019 that brain death does not mean demise of every neuron. Discussion: This case raises important questions about the types of movements that should be “allowed” during the determination of brain death to avoid delays in diagnosis.
ISSN:1052-3057
1532-8511
DOI:10.1016/j.jstrokecerebrovasdis.2020.104913